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City of New York MEDICAID CONSULTANT in New York, New York

Job Description

YOU MUST BE PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE.

The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to medically fragile and vulnerable individuals who require assistance with activities of daily living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the Assisted Living Program, and Homebound Medicaid.

Home Care Services Program (HCSP) is recruiting for one (1) Principal Administrative Associate II, to function as a Medicaid Consultant within the Central Intake Unit, who will:

  • Interpret Medicaid policies and procedures for assigned cases for individuals applying for or in receipt of services through one of the CASA offices, the Managed Long-Term Care (MLTC) Program, the Assisted Living Program (ALP), and the Field Services/Homebound Unit to ensure that cases are processed in compliance with Federal, State, and City Guidelines.

  • Supervise and distribute work schedules/assignments to the Central Intake Team, provide a timetable for efficient completion of work and ensure adequate coverage during the hours of operation.

  • Provide second-level sign-off approval for all adverse case actions to ensure that the cases are properly documented, and that the appropriate processing protocols are applied.

  • Conduct random review of completed cases to determine if the proper decision was made based on the documentation provided.

  • Conduct meetings with Central Intake Team to advise on problems identified in their team and provide written reports of meetings indicating problems found, resolution(s) initiated, and recommendations for corrective training.

  • Conduct training sessions to provide Central Intake Team Supervisors, and/or Clerical Associates with correction and feedback based on the unit review to reduce or eliminate Quality Control errors.

  • Review computer error reports, checks for repetition of specific errors and follow up to determine reason for the errors. Review the control process to ensure that it is operating with maximum efficiency.

  • Provide assistance to Central Intake Team Supervisors, and/or Clerical Associates on cases requiring resolution for high priority actions such as Immediate Needs, Fair Hearing and Quality Assurance issues.

Work Location: 470 Vanderbilt Avenue, Brooklyn, NY, 11238

Hours/Schedule: 9:00 am - 5:00 pm (FLEX)

Qualifications

  1. A baccalaureate degree from an accredited college and three years of satisfactory full-time progressively responsible clerical/administrative experience, one year of which must have been in an administrative capacity or supervising staff performing clerical/administrative work of more than moderate difficulty; or

  2. An associate degree or 60 semester credits from an accredited college and four years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience described in "1" above; or

  3. A four-year high school diploma or its educational equivalent approved by a State's department of education or a recognized accrediting organization and five years of satisfactory full-time progressively responsible clerical/administrative experience including one year of the administrative supervisory experience as described in "1" above;

  4. Education and/or experience equivalent to "1", "2", or "3" above. However, all candidates must possess the one year of administrative or supervisory experience as described in "1" above. Education above the high school level may be substituted for the general clerical/administrative experience (but not for the one year of administrative or supervisory experience described in "1" above) at a rate of 30 semester credits from an accredited college for 6 months of experience up to a maximum of 3½ years.

Additional Information

The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.

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